Tag Archives: plastic surgery

General Surgery, Global Surgery, Plastic Surgery, Print Release

PUBLISHED: Basal Cell Carcinoma Excision from the Lower Lip with Versatile Keystone Flap for Vascularized Skin Replacement

Basal Cell Carcinoma Excision from the Lower Lip with Versatile Keystone Flap for Vascularized Skin Replacement
Geoffrey G. Hallock, MD
Sacred Heart Campus, St. Luke’s Hospital

Maintenance of intact skin throughout the body is essential to prevent dehydration, to act as a barrier to infection, to allow unrestricted movement, and to provide a normal appearance. A flap is a piece of body tissue, usually skin and fat, that always has its own blood supply. Therefore, a flap can be moved anywhere it can reach without worrying about the circulation present at the place that needs it, which is called the recipient site. When compared with all other possible choices, a flap best meets all the requirements for any area needing skin replacement.

The keystone type flap as one such option is so named because its design has the shape of the keystone of a Roman arch. If taken from loose tissues adjacent to a defect, it can be simply cut and advanced for any necessary skin coverage. Direct closure of the donor site where this flap comes from is possible so that usually a quite good overall cosmetic result is also obtained. These virtues are shown as an overview in this video where a keystone flap is transferred after removal of a common basal cell skin cancer from the lower lip.

Plastic Surgery, Print Release

PUBLISHED: Local Tissue Rearrangement for Hypertrophic Chemical Burn: Z-Plasty and VY-Plasty

Local Tissue Rearrangement for Hypertrophic Chemical Burn: Z-Plasty and VY-Plasty
Daniel N. Driscoll, MD, FACS¹; Lisa Gfrerer, MD, PhD²; Robert Dabek, MD³; Aleia M. Boccardi*
¹Shriners Hospitals for Children – Boston
²Harvard Plastic Surgery Combined Residency Program
³Massachusetts General Hospital
*Touro University College of Osteopathic Medicine

Hypertrophic scarring following burn injuries has been shown to occur in up to 70% of patients, potentially causing both long-term psychological and physical morbidity. Increased rates of depression and anxiety are seen to arise from aesthetic dissatisfaction, affecting patient rehabilitation and subsequent societal interaction. Mobility is jeopardized from contractures that develop within the damaged tissue, leading to decreased range of motion and function of the area. Both sequelae leave the patient with an overall decreased quality of life.

Surgical techniques involving local tissue rearrangement, including Z-plasty and VY-plasty can be employed to improve both the function and cosmetic effects of burn scars. Essentially, these techniques illicit a decrease in tension through a lengthening of contracted tissue of up to 50–70%, allowing for better static alignment and increased mobility over joint surfaces. This video depicts the combination of both tissue rearrangement techniques as applied to hypertrophic scar contractures resulting from prior burn injuries. These techniques are an invaluable part of a reconstructive surgeons’ armamentarium when approaching scar revision.

Plastic Surgery, Print Release

PUBLISHED: Reconstruction of a Large Nasal Cutaneous Defect Using Nasolabial and Rhomboid Flaps

Reconstruction of a Large Nasal Cutaneous Defect Using Nasolabial and Rhomboid Flaps
Ajaipal S. Kang, MD, FACS
UPMC Hamot

Resection of cutaneous malignancies may result in substantial skin defects. Often, skin grafting is a first-line option for reconstruction of such defects but may be limited by poor cosmetic outcomes and incomplete graft acceptance. Accordingly, skin flaps, tissue rearrangement techniques, and more complex procedures may be needed. This case report presents the successful use of a combination of nasolabial flap and rhomboid flap for reconstruction of a 3-cm × 2-cm left nasal sidewall and ala skin defect that remained following a basal cell cancer Mohs resection. The flaps were quickly and easily fashioned, did not require any special instruments, and resulted in a good cosmetic outcome. There were no wound complications and the flaps healed completely with excellent contour, texture, thickness, color match, and complete patient satisfaction. This case is an example of the technical aspects of successful planning, elevation, and inset of a nasolabial flap and rhomboid flap.

Plastic Surgery, Preprint Release

Preprint Release: Bilobed Nasolabial and Rhomboid Flaps for Repair of a Left Nasal Ala Defect Following Basal Cell Cancer Excision

Bilobed Nasolabial and Rhomboid Flaps for Repair of a Left Nasal Ala Defect Following Basal Cell Cancer Excision
UPMC Hamot

Ajaipal S. Kang, MD
Cosmetic, Plastic & Reconstructive Surgery Specialist
UPMC Hamot

In this case, Dr. Ajaipal Kang at UPMC Hamot performs a bilobed nasolabial flap and a rhomboid flap to close a left nasal ala defect that remained following an excision of a basal cell cancer.

General Surgery, Global Surgery, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Left Mastectomy Wound Closure with Left Latissimus Dorsi Musculocutaneous Local Flap

Left Mastectomy Wound Closure with Left Latissimus Dorsi Musculocutaneous Local Flap
Hospital Leonardo Martinez, Honduras

Geoffrey G. Hallock, MD
Plastic Surgery Consultant
Sacred Heart Campus, St. Luke’s Hospital
Allentown, Pennsylvania

Yoko Young Sang, MD
Resident Physician
General Surgery
Louisiana State University Shreveport

In this case, Dr. Hallock closes the wound that was left behind following a mastectomy using a latissimus dorsi musculocutaneous local flap. This was performed during a surgical mission in Honduras with the World Surgical Foundation.

General Surgery, Global Surgery, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Squamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the Thigh

Squamous Cell Carcinoma Excision from Right Forearm with Split-Thickness Skin Graft from the Thigh
Hospital Leonardo Martinez, Honduras

Geoffrey G. Hallock, MD
Plastic Surgery Consultant
Sacred Heart Campus, St. Luke’s Hospital
Allentown, Pennsylvania

In this case, Dr. Hallock performs a right forearm squamous cell carcinoma excision followed by a split-thickness skin graft from the thigh. It was filmed in Honduras on a surgical mission with the World Surgical Foundation.

General Surgery, Global Surgery, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Basal Cell Carcinoma Excision from Lower Lip with Keystone Flap Reconstruction

BASAL CELL CARCINOMA EXCISION FROM LOWER LIP WITH KEYSTONE FLAP RECONSTRUCTION
Hospital Leonardo Martinez, Honduras

Geoffrey G. Hallock, MD
Plastic Surgery Consultant
Sacred Heart Campus, St. Luke’s Hospital
Allentown, Pennsylvania

In this case, Dr. Hallock performs a basal cell carcinoma excision followed by a Keystone flap reconstruction. It was filmed in Honduras on a surgical mission with the World Surgical Foundation.

General Surgery, Pediatrics, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Contracture Release and Full-Thickness Skin Graft to Volar Index Finger with K-Wire Insertion


Contracture Release and Full-Thickness Skin Graft to Volar Index Finger with K-Wire Insertion
Shriners Hospitals for Children – Boston

Jonathan Friedstat, MD
Plastic and Reconstructive Surgery
Shriners Hospitals for Children – Boston
Massachusetts General Hospital

Jonah Poster
Medical Student
Icahn School of Medicine at Mount Sinai

This case centers around a young male patient with a 1-year-old burn scar on his volar index finger that keeps the finger flexed and prevents it from being straightened. Here, Dr. Friedstat releases the contracture and places a full-thickness skin graft from the right groin crease. A K-wire was also used to prevent flexion of the finger during the healing process.

General Surgery, Pediatrics, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Bilateral Dorsal Foot Scar Contracture Release with Split-Thickness Skin Grafts from the Anterior Thigh


Bilateral Dorsal Foot Scar Contracture Release with Split-Thickness Skin Grafts from the Anterior Thigh
Shriners Hospitals for Children – Boston

Jonathan Friedstat, MD
Plastic and Reconstructive Surgery
Shriners Hospitals for Children – Boston
Massachusetts General Hospital

Jonah Poster
Medical Student
Icahn School of Medicine at Mount Sinai

In this case, a 5-year-old male with burn scars undergoes a bilateral dorsal foot scar contracture release with split-thickness skin grafts from the anterior thigh.

Announcement, Pediatrics, Plastic Surgery, Preprint Release

PREPRINT RELEASE: Pulsed Dye and Fractional CO2 Laser Therapy for Treatment of Burn Scars


Pulsed Dye and Fractional CO2 Laser Therapy for Treatment of Burn Scars
Shriners Hospitals for Children – Boston

Branko Bojovic, MD
Chief of Plastic, Reconstructive, and Laser Surgery
Shriners Hospitals for Children – Boston

Robert J. Dabek, MD
Research Fellow, Division of Plastic and Reconstructive Surgery
Massachusetts General Hospital
Harvard Medical School

Harrison McUmber
Medical Student
Tufts University School of Medicine

In this case, Dr. Bojovic uses both pulsed dye laser therapy and fractional CO2 laser therapy to treat burn scars on a female pediatric patient.